Nagpuri Gappa: In Conversation With Oncosurgeon Dr Abhinav Deshpande

I dedicate my oncosurgery career to her,” says the young oncosurgeon.

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Talking about the fragility of humans, Samuel Decker Thompson has rightly said that we are just a car crash, a diagnosis or a phone call away from becoming a completely different person. Talking to Dr. Abhinav Deshpande, I realized how true Thompson’s words are, just an incident is enough to change our lives forever.

“I was a general surgery resident at KEM hospital Mumbai when someone very close to me was diagnosed with breast cancer. When she was being taken to the OT, I decided that I wanted to take up oncosurgery. Because I felt that oncosurgery is a branch that needs more innovation and more dedication on the doctor’s part. Experiencing the pain and emotional and physical trauma of a cancer patient and his family first hand, I realized that this a challenge I am willing to take and work hard towards making lives of cancer patients slightly better. So, in a way, I dedicate my oncosurgery career to her,” says the young oncosurgeon.

Dr Abhinav Deshpande is a certified oncosurgeon. He has recently completed his super-specialty in cancer surgeries from Ahmedabad and would be soon joining the robotic oncosurgery programme at Manipal Hospital, Bangalore.

Talking about the difference between oncosurgeons and oncologists, he says, “To put it simply, the doctors who are certified to treat a cancer patient with medicines and chemotherapy are oncologists. Whereas the doctors who are certified to perform surgery to treat cancer or remove the source of cancer are oncosurgeons.”

Surgical oncology is the branch of surgery applied to oncology; it focuses on the surgical management of tumors, especially cancerous tumors. Cancer was once synonymous to death, but with oncosurgery, patients have a better chance at survival.

With the passing day, as the disease becomes more and more challenging, the treatment of cancer too is developing new techniques to try and cure this disease. Robotic oncosurgery is one of them.

Robot-assisted surgery integrates advanced computer technology with the experience of skilled surgeons. This technology provides the surgeon with a 10x magnified, high definition, 3D-image of the body's intricate anatomy. The controls in the console allow the surgeon to manipulate special surgical instruments that are smaller, as well as more flexible and manoeuvrable than the human hand. The surgeon is thus in complete control of the surgical procedure. The robot helps replicate the surgeon’s hand movements, while minimizing hand tremors. The surgery is thus operated with enhanced precision, dexterity and control even during the most complex procedures.

Talking about the advantages and practicality of robotic oncosurgery, he says, “There are a few areas in the human body that are not easily accessible for a human hand, because it lacks the flexibility and dexterity. That is where the robot comes into play. With a robotic assistant, it becomes easier to operate with precision on the areas inaccessible to the human hand. So our limitations are taken over by the robot.”

So is it something where the surgeon is not required at all?

“We can say that it is ultimately the surgeon who is operating with a finer degree of ease. The system is what we call, a master-slave system, wherein the surgeon has all the control of the system. So, the entire surgery is performed by the surgeon and the movements are transmitted to the robotic hand. Basically, the movements of your wrist or the movement of your fingers is transmitted to the robot through an electro-mechanical interface. The doctor is sitting away from the patient at a console, where he has the 3D image of the tumor or the area that is being operated upon. The surgeon performs the surgery at the console and his movements are transmitted at the operation table where the robotic hand is inside the patient’s body,” he explains.

“As the robotic surgery is less invasive as compared to an open surgery, there is minimal or no scarring involved. So the post-operative pain, the risk of wound infections and the chance of damaging normal tissues is also reduced,” he adds.

The surgeon’s actions have to be really precise while performing a robotic surgery as even a slightest mistake can cost the patient’s life. To attain this level of precision, the surgeon has to undergo rigorous training. Dr Abhinav Deshpande has received a fellowship by the Vattikuti Foundation, wherein he will be trained in robotic oncosurgery at the Manipal Hospital, Bangalore.

Talking about the yearlong fellowship and the rigorous training, he says, “ It is a rigorous training programme where they train us in this type of surgery through multiple tasks. For example, one of the task that I’ll be supposed to perform is peeling the outermost layer of the grape and suturing it back. So, I will be sitting at the console and controlling the robotic arms that peel the skin of the grape and suture it back.”

I remember the time when we used to say that AI is the future, but talking to Dr Deshpande and listening to the medical advancements, it feels like we are living in the future.

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